Having coverage doesn’t mean you have access to care

Hello. Dr. Keith Smith with you – Surgery Center of Oklahoma. Thank you for joining us in this video blog series.

What does it mean when a patient from Canada flies to Oklahoma City and has surgery here in our facility? What does that mean? That means that they have coverage, but they really don’t have any access to care.

What does it mean when a patient has one of these new Obamacare cards in their wallet, but their out-of-pocket experience here at the Surgery Center of Oklahoma is better for them than if they actually used that Obamacare benefit? What does that mean? That means they have coverage, but they really don’t have access to care… not that they’re not paying for completely out of their own pockets. And our prices here at the Surgery Center – the ones we have listed online – are favorable enough to the patients that many of them take advantage of that.

What does it mean when people say that single-payer is the solution? We’ve received so many lively responses to my single-payer comments, that I thought I’d take this a step further.

Single-payer as a concept, after all, is really a distraction because it focuses on coverage. And it doesn’t give any consideration to cost. Cost of care in the United States is really the problem. After all, if the cost of healthcare is reasonable, then coverage is an afterthought. Coverage and insurance, which is a necessary thing, is there to cover uncertainty – not to cover the equivalent of a healthcare oil change

What the United States healthcare system needs – and it is desperately flawed, make no mistake; I am not a defender of the current healthcare system – what it needs is the same free-market competition and discipline every other industry must endure.

Single-payer is a true distraction. It is a faulty premise that is way downstream of the cost problem.

People in countries that have single-payer coverage have just that. They have coverage, but they really don’t have a lot of access to care. And more and more stories of the disaster of single-payer in the many countries that have adopted this are becoming clear and are leaking out every day.

When somebody wants to talk about single-payer, try to get them to talk a little bit about the cost of care and address the cost of care. What is it that drives cost down and quality up? It’s the free market. Every single time; no other economic mechanism is more powerful.

I thought I would make even more comments about single-payer and see what sort of lively exchange results. Thank you for joining us. We’ll see you next time.